1. The impact of Recovery Support on FGDM
Presented by: Kristin Noecker & Darren Hoffer of The RASE Project

2. The RASE Project
Offices in Harrisburg, Carlisle, Lancaster, Lebanon, York and Hanover serving a nine county area of Dauphin, Cumberland/Perry, Lancaster, Lebanon, Franklin, Fulton, Adams and York counties
Advocacy for those seeking or already in recovery
Voice for anonymous recovery community…

3. RASE Project Services Transitional Housing and life skills development
Speaker’s Bureau- IMOW
Training and education
Coordination of Care: Buprenorphine
Recovery Specialist Program
Interventions
Weekly Introduction to Recovery Groups
Recovery Events

4. What is Addiction
It is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.
Nora D. Volkow, MD Director, National Institute on Drug Abuse

5. Common Questions Is addiction a disease or a bad behavior?
Is addiction voluntary or involuntary?
How do we best treat addicts?
How does the family play a role in this?

6. What Defines A Disease? 1. Pattern of Symptoms 2. Chronic
3. Progressive
4. Subject to Relapse
5. Treatable

7. A Lifestyle Disease? Asthma Heart Disease Hypertension
Type II Diabetes

8. Addiction is NOT caused by
Irresponsible use
Emotional stress
An unhappy childhood

9. Addiction IS caused by Being biologically susceptible
Taxing the susceptibility with use

10. POLYGENIC INHERITANCE-
Initial theories of a single “addictive gene” have essentially been disproved by research. However, studies do show that multiple genes play a role in the transmission of addiction from one generation to another

11. Erickson’s Psychosocial Stages of Development-
0-1 yrs. Hope - Trust Vs. Mistrust
2-3 yrs. Will - Independence vs. Doubt
4-5 yrs. Purpose - Initiative vs. Guilt
6-12 yrs. Competency - Industry vs. Inferiority
13-19 yrs. Fidelity - Identity vs. Role Confusion
20-24 yrs. Love - Intimacy vs. Isolation
25-64 yrs. Care - Generativity vs. Stagnation
65+ yrs. Wisdom – Ego Integrity vs. Despair

12. Genetic Predisposition
No single gene for addiction
Dr. George Uhl and colleagues at NIDA’s Intramural Research Program (IRP) in Baltimore, Maryland have linked at least 89 genes to drug abuse and dependence
This technique is called genome-wide association studies (GWAS).
The ability to study variant forms of each our 30,000 or so genes and then correlate findings

13. Non-Biological Risk Factors
Cultural & Social Values
Developmental Variations
Personality Difference
Abuse, Trauma
Parents use and attitudes
Community/Social attitude
Perception

14. Different levels of substance use prior to final stage of addiction.
Use/ Experimenting
Misuse (infrequent use at predictable times)
Abuse (plans are centered on substance use)
Dependency
Addiction

18. Addiction is a family disease
Addiction is the no.1 lifestyle disease in America. It effects 1 in 4 adults in the US … And 1 in 3 families have at least 1 addicted family member - SAMHSA 2008

19. Addiction is a progressive disease.
It may start out with casually accepting unacceptable behavior.
A few years down the road the behavior has slowly grown more out of control, but it becomes the ‘norm’.
One ends up with chaos in their own home that a few short years ago would have been unthinkable.

20. How the family plays a role in addiction
One of the biggest challenges to family recovery is the belief that everything will be Ok if the family can just “fix” their loved one who is addicted to alcohol or drugs.
Just as an individual is responsible for their own recovery, families are responsible for theirs. Addiction hurts the while family, it is essential that the solutions are designed to restore the whole family.

21. Enabling- to make able; give power, means, competence, or ability to; authorize:
In an attempt to cover for & protect the addict & the family, we actually create an environment that can empower the addict’s behavior.
The family learns to keep secrets, no matter how bad the chaos and insanity become.
Frog in the water

22. The alcoholic comes home late and she is too drunk to get the key into the front door. After several futile attempts, she decides to pass out in the front yard!
What would your reaction be?

23. The Rescuer
The “rescuer”, AKA, the “caretaker”, doesn’t let the incident become a “problem”. Since they have been waiting up anyway, they go out into the yard, get the alcoholic up, clean them up and put them to bed.
The caretaker may lie or make excuses to cover up for the mistakes and protect the addict.
As the disease progresses and problems escalate, the caretaker takes on responsibilities that were once the addicts

24. The Provoker
The “provoker” often reacts by punishing the alcoholic for their actions. They scold, ridicule and belittle.
They are angry and make sure that the addict and everyone else in the world knows it.

25. The Martyr
The “martyr” is ashamed of the alcoholics’ behavior and they let them know by their subtle actions
They may sulk, pout and isolate. Quietly they try to make the addict feel guilty for the behavior and re-instill within themselves that they are a victim.

26. Which is the Enabler?
The Rescuer
The Provoker
The Martyr

27. All of them!
Although these examples may be somewhat exaggerated, they are very typical of what life becomes like in an addicted household. Depending upon the circumstances, family members may fall into one of these roles, or they may switch back and forth between them all.
Although they are sincerely trying to solve the disease, the are actually contributing to the disease and the ongoing unmanageability associated with the disease.

28. The Rescuer
Enables by not allowing the addict to face the consequences of their own actions.

29. The provoker & the martyr
These 2 enablers are similar because their reactions take the focus away from the addict.
Both have a primary goal of manipulation through guilt.
But if he/she is truly addict, the reaction will not be to own up to the mistakes, but to try to escape them once again, in the drug.

30. There is another reaction…
If the alcoholic wakes the next morning to find the household functioning normally, the only thing left for him/her to face is their own behavior.
Any feelings of embarrassment or shame brought on by her passing out in the front yard will belong to the addict themselves.

31. If the other family members continue to meet their own needs and not focus on “fixing” the addict, they have done their part.
They also allow the addict to take responsibility for themselves.

32. Why people enable
Love and Caring- We have a genuine desire to protect the individual from harm
Compassion- We want to help and support our loved one.
Attachment- we do not want to jeopardize our relationship with the person
Denial- We think the problem will get better or go away if we ignore it.
Self-esteem- We feel better when new think we are control of the situation
Self-doubt- Unresolved childhood issues cloud our perception and judgement
Fear- We are afraid of the person’s temper, threats, and erratic behavior.

33. What is Recovery Support
Recovery Planning--Recovery planning could involve, but is not limited to, identifying triggers for use, developing a relapse prevention plan, and building or rebuilding a support network.
Relationship Building--Recovery specialists assist participants with developing social skills needed to establish or maintain relationships. Often, this requires assisting participants with repairing, rebuilding, or establishing new support networks in order to achieve and maintain lasting recovery.
Leisure Activity Planning—participants benefit from recovery support services when they learn new ways to have fun and enjoy life without the inclusion of drugs or alcohol. Recovery specialists can assist the client with skill building efforts related to such things as time management, connecting with positive social activities and supporting/coaching the client in social situations.
Substance Use Behavior Education--Addiction is a chronic, relapsing illness. The recovery specialist can assist with educating a client in relapse prevention and in identifying relapse indicators as part of developing a relapse prevention plan.

34. Why is Recovery Support Important in the recovery process?
What we do
Why we do it
Transportation - How to access and use public transportation
Housing - Where to go to explore housing resources
Basic Needs - Where to go to get help with food and clothing
Health Issues - Location of public health offices, free clinics or community mental health offices
Legal Problems - How to access legal aid services
Employment - Location of local employment assistance or training programs
Education - Location of educational resources for completion or continuation of degree or training
Support Groups - Location of local, community-based support groups such as Alcoholics Anonymous, Narcotics Anonymous, Ala- Teen, Celebrate Recovery, Smart Recovery, and others.

35. What is the difference between Recovery Support, Treatment & Sponsorship
Addiction Counselor
Recovery Specialist
Sponsor
Organizational Context
Works within organizational hierarchy of treatment organization and with direct supervision
Organizational settings span treatment organizations, allied service organizations and recovery community organizations; varied degree of supervision
Minimal hierarchy and no formal supervision
Service/Support Framework
Works within a particular organizational treatment philosophy
Works across multiple frameworks of recovery via choices of those with whom they work
Works within beliefs and practices of a particular recovery fellowship
Service/Support Relationship
Significant power differential; extreme separation of helper/ helped roles; explicit ethical guidelines; high external accountability
Minimal power differential; ethical guidelines being developed; moderate external accountability
Minimal power differential; support is reciprocal; relationship governed by group conscience; no external accountability
Style of Helping
Formal, personally guarded and strategic
Variable by organizational setting but generally personal and informal
Informal, open and spontaneous
Use of Self
Self-disclosure discouraged or prohibited
Strategic use of one’s own story; role model expectation
Temporal Orientation
Considerable focus on past experience
Focus on present: what can you do today to strengthen your recovery?
Variable by fellowship and stage of recovery of sponsee
Role of Community in Recovery
Intrapersonal & interpersonal focus; minimal focus on ecology of recovery; minimal advocacy
Focus on linking to community resources and building community recovery capital; significant advocacy work
Intrapersonal & interpersonal focus; some focus on ecology of recovery; some advocacy
Documentation
Extensive and burdensome
Moderate and growing
None
Money
Works as paid helper; client or third party pays for service
Works in paid or volunteer role; service may be paid for by person being coached or a third party
Provides support only as part of one’s own service work; no fees paid to sponsor or recovery fellowships

36. How a family member can participate
Education
Entering their own program of recovery
Establishing healthy boundaries
Hope

37. Questions?